Rapid Absorption of a Spontaneous Primary Intraventricular Hemorrhage

Spontaneous primary intraventricular hemorrhage (IVH) is a rare type of intracranial hemorrhage that can be concentrated in one or more ventricles. The clinical symptoms after bleeding are diverse, if there is significant bleeding or hydrocephalus, external ventricular drainage (EVD) treatment is often required. Absorption of the hematoma after ventricular hemorrhage usually takes several weeks, and there are very few articles in the literature on hematoma absorption. As far as we know early spontaneous disappearance of spontaneous primary IVH has not previously been reported in the literature. Herein, we describe a rare case of spontaneous primary IVH that rapidly disappeared without surgical intervention. The patient, a 73-year-old male, was admitted to the hospital for "unclear speech for 16 hours". An initial head computed tomography (CT) scan showed significant accumulation of blood in both lateral ventricles, the third ventricle, midbrain aqueduct, and fourth ventricle, as well as acute hydrocephalus. The patient was conscious and did not undergo EVD treatment. After 24 hours, head CT re-examination showed that the accumulated blood had been significantly absorbed, and hydrocephalus had improved. Three days later, head CT re-examination showed that the accumulated blood in the ventricles had been absorbed, and the patient did not experience any discomfort. Following observation for a few more days, he was discharged from the hospital.